Abstract

Chronic congestive heart failure is connected with increased sympathetic nervous system activity and decreased parasympathetic nervous activity - that contributes to the progression of disease and increase of mortality. It is very important to search new drugs for improvement of sympatho-parasympathetic activity in heart failure. Mildronate has been synthesised at Latvian Institute of Organic Synthesis. It is metabolic drug that modulates individual stages of energy metabolism in myocardium. Mildronate belongs to the group of cytoprotectors / antihypoxants and ensures cellular protection and energy supply in conditions of ischemia and high stress.
To investigate the effect of Mildronate upon carotid baroreflex function in heart failure.
60 pts. with stable heart failure(no changes in medical therapy within the last 2 months, aged 51-76 yr., II–III class (according to NYHA) were randomly assigned in double-blind fashion to receive either 1000 mg of Mildronate or placebo. At the beginning of study and after 12 weeks of treatment beat-to- beat heart rate and finger mean arterial pressure were monitored non-invasively. Bradycardic and hypotensive reaction to carotid baroreceptors activation were studied, applying neck suction (-60 mmHg for 5s).
Mildronate (dose 1000 mg/day) in addition to standard therapy is associated with no significant decrease of mean arterial pressure, diastolic blood pressure and heart rate. Systolic blood pressure (p<0.05) decreases and bradycardic and hypotensive reactions to carotid baroreceptors activation increase (p<0.01) significantly after Mildronate therapy.
12-week treatment period with Mildronate significantly improves sympatho-parasympathetic balance in patients with stable heart failure.